Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia.
Aboriginal Student Success Officer, Collaborative Evaluation and Research Group, Federation University, Churchill, Victoria, Australia.
Disabil Rehabil. 2024 Apr;46(8):1438-1449. doi: 10.1080/09638288.2023.2194681. Epub 2023 Apr 8.
Aboriginal and Torres Strait Islander People with a disability continue to experience barriers to service engagement such as mistrust of government services, lack of culturally appropriate support, marginalisation and disempowerment. This meta-synthesis reviews current literature regarding these experiences to explain why services are underutilised. The meta-synthesis was conducted using a meta-ethnographic approach to synthesise existing studies into new interpretive knowledge. The approach was supported by a search using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Ten original research papers utilising a qualitative methodology were extracted. Synthesis of the articles revealed four concepts that were developed into a conceptual model. These include:1) History Matters; 2) Cultural Understanding of Disability Care; 3) Limitations to Current Service Provision; and 4) Delivery of Effective Services. Disability services do not adequately consider the cultural needs of Aboriginal and Torres Strait Islander People or communicate in a culturally appropriate manner. There are expectations that Aboriginal and Torres Strait Islander People acknowledge their disability in alignment with western definitions of disability in order to access services. More work is needed to align disability services with culturally appropriate support to provide better health outcomes.Implications for RehabilitationAboriginal and Torres Strait Islander people with a disability continue to experience barriers to service engagement which must be addressed.An essential gap that must be filled in providing disability services to Aboriginal and Torres Strait Islander people is the acknowledgment of culture as a resolute influence on all client interactions with providers.A cultural model of disability may better align with the experiences of Aboriginal and Torres Strait Islander people than current medical and social models used in healthcare.Disability services need to align better with culturally appropriate support to provide better health outcomes for Aboriginal and Torres Strait Islander people.
残疾的原住民和托雷斯海峡岛民继续面临服务参与的障碍，例如对政府服务的不信任、缺乏文化上适宜的支持、边缘化和无权。这篇元分析综述了当前关于这些经验的文献，以解释为什么服务利用不足。元分析采用元民族志方法进行，即将现有研究综合为新的解释性知识。该方法得到了使用系统评价和荟萃分析的首选报告项目（PRISMA）进行的搜索的支持。提取了十篇使用定性方法的原始研究论文。对文章的综合揭示了四个概念，这些概念被发展成一个概念模型。这些概念包括：1）历史很重要；2）对残疾护理的文化理解；3）当前服务提供的局限性；4）提供有效的服务。残疾服务没有充分考虑原住民和托雷斯海峡岛民的文化需求，也没有以文化上适宜的方式进行沟通。期望原住民和托雷斯海峡岛民按照西方对残疾的定义承认自己的残疾，以便获得服务。需要做更多的工作来使残疾服务与文化上适宜的支持保持一致，以提供更好的健康结果。
康复的意义
残疾的原住民和托雷斯海峡岛民继续面临服务参与的障碍，必须解决这些障碍。
在向原住民和托雷斯海峡岛民提供残疾服务方面，必须填补一个重要的空白，即承认文化是所有客户与提供者互动的决定性影响因素。
残疾的文化模型可能比医疗保健中当前使用的医学和社会模型更能与原住民和托雷斯海峡岛民的经历保持一致。
残疾服务需要更好地与文化上适宜的支持保持一致，以改善原住民和托雷斯海峡岛民的健康结果。
